Intracranial Mesenchymal Tumor With Rare EWSR1 :: CREM Gene Fusion in an Older Adult Woman: A Case Report and Review of the Literature.
Angcheng Li, Menglan Huang, Yanfei Zhang et al.
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Case in brief
A 60-year-old woman with a history of breast carcinoma presented with a right frontal intracranial mass. Histology showed stellate and spindle cells in abundant myxoid stroma, with positivity for EMA, CD99, desmin, and CD163. Molecular analysis identified an EWSR1::CREM fusion, supporting the diagnosis of an intracranial mesenchymal tumor. After gross-total resection, she remained disease-free at 17 months.
What made this case unusual
The patient’s age was notable: at 60, she was the second-oldest reported patient with an EWSR1::CREM fusion-positive intracranial mesenchymal tumor.
Diagnostic / clinical pearl
In a primary intracranial mass, stellate or spindle-cell morphology with abundant myxoid stroma should prompt consideration of this tumor type; molecular identification of EWSR1::CREM supports classification.
Why it matters
The tumor’s histomorphology is broad and its histogenesis and outcomes remain uncertain, so recognizing and characterizing additional cases can inform understanding of this molecular subtype.